Occupational cancers, an invisible “epidemic”

At 63, just retired, the husband of Daniel Funnel, chief technician at the Latte Factory, in Prue, Ur-et-Loir, fell ill. Cancer of the pleura. He died in 2009 in horrific circumstances, ten months after diagnosis,” says his wife, who is herself a former employee of this asbestos sealing company. According to her, dozens of workers at this site have died of cancer related to this substance, and others are still getting sick.. “Furthermore, I am not immune because, as a bilingual secretary, I have been showing the plant to German clients,” Danielle confirms.

When they are informed that they have been exposed to a carcinogen, employees can relate their illness to their work. But in the vast majority of cases, this association has not been proven, neither by them nor their doctor, who tend to criminalize smoking. Occupational cancer is cancer caused by working conditionsposes Benoit de Labross, Occupational therapist. But apart from mesothelioma, the cancer of the asbestos-specific pleura, there are no particular characteristics of occupational cancers from a medical point of view. Lung cancer can be due to asbestos, arsenic, tobacco … “

Too long delays between exposure and disease onset

However, it has been shown that carcinogens to which certain functions are exposed increase the risk of developing cancer. The accumulated knowledge in experimental biology, toxicology, and epidemiology determines the link between chemical (solvents, diesels, pesticides, crystalline silica, etc.), physical (ionizing radiation, etc.) and biological (viruses), or even night work, and so on. On the other hand, cancers of the lung, pleura, breast, bladder, larynx, kidney, etc.“,” Emily Connell, a researcher at the National Institute for Demographic Studies (INED), reports.

Occupational cancers, however, catch on to disappear. First, since a delay of ten, twenty, thirty or more years between exposure and the onset of pathology complicates causation, this is difficult to establish since the person exposed in his work is often unaware of the risks involved. Then, because city doctors and hospital workers, who are not trained in this question, rarely ask their patients about their careers.

According to the Cancer Control Plan 2014-2019, 14,000 to 30,000 of the 400,000 cancers detected each year in France are of occupational origin. For Tony Musso, a researcher at the European Trade Union Institute, Etui (1), it’s just “Visible Iceberg Head. About 10% of all cancers are related to work, according to a 2017 European study“,” He says. While other studies give much lower estimates, around 2 to 4%, their criteria are often disputed by experts, such as Emily Connell: About twenty carcinogens are taken into account, while tens of thousands of chemicals are used, of which very few are tested. »

obstacle course

In 2017, the Sumer (Medical Surveillance of Employees’ Exposure to Occupational Hazards) survey, coordinated by the Department of Research, Studies and Statistics (DRS) and the Ministry of Labor, showed that 10% of employees were exposed to a carcinogenic chemical in the week prior to the survey. This percentage rises to 11% in agriculture, 14% in industry, and 31% in construction.

Precarious workers, employees of subcontracting companies and young people, especially trainees, are overrepresented. Over the course of their entire professional life, employees are occupationally exposed to ten or fifteen distinct carcinogens, which significantly increase the risk of developing cancer. Annie Tibode supports Mooney, a sociologist at the National Institute of Health and Medical Research (Inserm) and a founding member of the Scientific Interest Groups on Occupational Cancer (Giscop). The Audit Bureau report (2) in 2008 indicated that “The cancer death rate among workers and employees is ten times higher than among executives and in the liberal professions.”.

Calculating occupational cancers is not an end in itself. Their identification makes it possible to unlock the right to reparation, that is, compensation for the harm inflicted on them. But recognizing it as an occupational disease with Social Security — which cares about 1,800 people each year — is an obstacle course. It requires demonstrating a person’s exposure and compliance with the criteria specified in the schedules from which there are no particular high-risk sectors, such as cleaning, cosmetics, and waste management. cumbersome procedures for patients and often limited material resources, Emily Connell says.

improve prevention

But in order to also improve prevention, the links between cancer and action can be clarified. Hiding occupational cancers means there is no struggle to prevent those that will spread in twenty or thirty yearswarns Annie Tibod Money. Knowledge aims to stop the epidemic. » Tony Musso adds: These cancers can be avoided by eliminating or replacing products, or when this is impossible, by taking measures to protect employees. »

In addition, the payment of allowances to be paid by the employer-financed Social Security branch, could constitute a lever to increase corporate awareness of the need to invest in prevention, which is less costly in the human and financial areas. Conditions rather than repair – which would represent a cost of €270-610 billion a year to society as a whole, according to a European study.

With the exception of mesothelioma, there is no surveillance system in France for cancers related to professional activity, such as the Nocca (Northern Occupational Cancer Study) project in the Nordic countries. However, in the fall of 2021, the French Public Health Authority announced the launch of Sicapro, a system for identifying sectors at high risk of developing cancer.

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